Patient involvement helps influence GP contracting decisions

The challenge

Our CCG is committed to ensuring that patients have access to high-quality general medical services. Our goal is to make sure that we provide the right services for our entire population, which make the best use of the resources available to us.

There are currently a number of General Practices in our area which are procured through an Alternative Medical Service Contract. These contracts are time-limited, and we had four practices whose current contracts were scheduled to expire on March 31 2020.  The CCG needed to consider how general medical services should be provided when these contracts expire, to ensure that we are commissioning high quality services for our entire population, which make the best use of the resources that we have, both now and in the future. A number of factors were part of this decision process, including finance, performance, sustainability, practice size, other local provision and local patient need.

We were not able to keep things as they were as the CCG has a legal obligation to offer the chance to bid on any new contract to all interested providers, including the existing provider, to ensure services continue to improve and offer the right support to their patients. 

What we did

We conducted an engagement exercise to understand the needs of patients at the practices, and consider how the practices are currently used, how many patients are registered at the practice, and the capacity of other practices in the area to take on more patients if required.

Patients were asked to give their views via a survey on what they thought their practice was doing well, anything they are not satisfied with and what was most important to them in the GP services that they received. It also explored the impact any changes to, or closure of, their current GP services would have, and what travel distance they considered reasonable to access GP services.

The survey was available online and in-practice, and also promoted through the CCG website, social media and local press, as well as through our contacts in the community and voluntary sector. We also spoke with a number of seldom heard groups who were representative of the practice profile, supporting them to fill in the survey where required, because we knew they might not always get the opportunity to share their views and make their voice heard. The results of the survey were cross referenced with the results of the national patient survey results for each practice.

The CCG also tested the market to understand if there was interest from providers for taking on the practices. Once we identified that there was sufficient potential interest, we put the contracts out to tender for potential providers to bid on.

 

To assist us with this and ensure we kept patients at the heart of the procurement process, we worked with local community and patient representatives, as well as Healthwatch Warwickshire, and invited them to take part. We used questions previously developed with patient groups for the procurement of GP services, which included questions on how the practice would keep patients at the heart of service delivery and how they would involve the patient groups, particularly seldom heard and vulnerable patients, in practice business. The group supported us by evaluating the patient experience elements of the responses. 

Who we worked with

We made contact with a number of local community and voluntary sector organisations to gather feedback and local views.

 

  • Foleshill Women’s Training (BME Women)
  • Ekta Unity (Older Asian women)
  • Hope Unity (Afro-Caribbean community inc dementia and carer support)
  • Carer’s Trust
  • Family Information Hubs (Coventry area)
  • Coventry Older Voices
  • Healthwatch Coventry
  • Healthwatch Warwickshire
  • Coventry Pride

The outcome

Our engagement with patients at each practice helped us to decide to put the contracts out to tender for providers to bid on, meaning patient feedback directly influenced our decision making.

Once the decision to proceed with the procurement was taken, we worked to set up a smaller patient reference group which included representation from local BAME communities, someone living with a long-term condition and a community and voluntary sector representative, who have been trained and supported to take part in the procurement exercise by helping review the patient and public involvement questions in the bid and review and score the bids we receive.

 

By following this process, local patients have had a say in who is awarded the contract to deliver services at the practices.

Next steps

Once the procurement exercise is complete, and if a provider or number of providers are successful in bidding for the contracts, they will be awarded the contract to provide general medical services at the practices.  

 

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